Provider Demographics
NPI:1770860009
Name:KRAUSE, KIMBERLY A (L AC)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:KRAUSE
Other - Last Name:HORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4 KELLOGG RD STE 6
Mailing Address - Street 2:
Mailing Address - City:ESSEX JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05452-2815
Mailing Address - Country:US
Mailing Address - Phone:802-662-5882
Mailing Address - Fax:
Practice Address - Street 1:4 KELLOGG RD STE 6
Practice Address - Street 2:
Practice Address - City:ESSEX JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05452-2815
Practice Address - Country:US
Practice Address - Phone:802-662-5882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-15
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT091-0134019171100000X
FLAP2999171100000X
NH245171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist